Improvement of sexual function in POEMS syndrome after combination therapy of Lenalidomide and dexamethasone.
Improvement of sexual function in POEMS syndrome after combination therapy of Lenalidomide and dexamethasone.
复制标题
来那度胺与地塞米松联合治疗 POEMS 综合征性功能的改善
DOI：
10.1186/s13023-016-0461-8
复制
发表时间：
2016-06-18
影响因子：
3.7
通讯作者：
Li J
中科院分区：
文献类型：
--
作者：
Yang H;Huang X;Cai Q;Wang C;Cao X;Zhou D;Li J
POEMS综合征是一种罕见的副肿瘤综合征，由于潜在的浆细胞肿瘤。性腺功能减退是POEMS综合征最常见的内分泌异常。目前尚无POEMS综合征经适当治疗后性腺功能减退和性功能障碍改善的资料。在这项单中心前瞻性研究中，评价了低剂量来那度胺和地塞米松联合治疗在改善POEMS综合征性和性腺功能方面的疗效。35例新诊断的POEMS综合征患者接受来那度胺（10 mg/d，共21 d）和地塞米松（40 mg/周，1次）治疗12个周期。对男性患者的国际勃起功能指数（IIEF）、女性患者的女性性功能指数（FSFI）、总睾酮、雌二醇和血管内皮生长因子（VEGF）水平进行了回顾性分析。88.8%（24/27）的男性和90.9%（10/11）的女性患者报告了性功能障碍。62.9男性17例（%），女性12例（25.0%）有性腺功能减退。治疗12个月后，平均总FSFI评分从17.1 ± 7.2增加到23.7 ± 7.2（p < 0.05）。唤醒、性高潮和性疼痛领域有明显改善。平均IIEF评分从12.9 ± 13.0增加到20.5 ± 18.4（p < 0.05）。治疗结束时勃起功能、性欲和性交满意度均明显改善。在两种性别中，VEGF水平与性功能改善之间没有关联。低剂量来那度胺联合地塞米松治疗可成功改善POEMS综合征患者的性功能。
POEMS syndrome is a rare paraneoplastic syndrome due to an underlying plasma cell neoplasm. Hypogonadism is the most common endocrine abnormality in POEMS syndrome. There is no data about improvement of hypogonadism and sexual dysfunction after appropriate treatment of POEMS syndrome so far. In this single-center prospective study, the efficacy of low-dose lenalidomide and dexamethasone combination therapy in the improvement of sexual and gonadal function in POEMS syndrome was evaluated. Thirty-five patients with newly diagnosed POEMS syndrome were treated with Lenalidomide (10 mg daily for 21 days) and dexamethasone (40 mg once per week) for 12 cycles. The international index of erectile function (IIEF) in male patients, the female sexual function index (FSFI) in female patients, total testosterone, estradiol and vascular endothelial growth factor (VEGF) levels were reviewed. Sexual dysfunction was reported in 88.8 % (24/27)male and 90.9 % (10/11) female patients. 62.9 % (17/27) male and 25.0 % (3/12) female patients had hypogonadism. After 12-month treatment, the mean total FSFI score had increased from 17.1 ± 7.2 to 23.7 ± 7.2(p < 0.05). The arousal, orgasm and sex pain domains had been improved significantly. The mean IIEF scores had increased from 12.9 ± 13.0 to 20.5 ± 18.4 (p < 0.05). Erectile function, sexual desire and intercourse satisfaction had improved significantly at the end of treatment. No association between VEGF levels and sexual function improvement was found in both genders. Combination therapy with low-dose lenalidomide plus dexamethasone is successful in improving sexual function in POEMS syndrome.